Project Details

Reducing newborn deaths by improving intrapartum fetal heart rate monitoring using the Moyo device

Milton Musaba, MBChB, MMed, PhD

Summary

BACKGROUND: Globally, poor intrapartum monitoring contributes to half of all stillbirths and one third of all early neonatal deaths. Intrapartum fetal heart rate monitoring (FHRM) to detect fetal distress, followed by appropriate and timely interventions can reduce the incidence of fresh stillbirths and neonatal morbidity. Use of the MOYO device, which continuously measures FHR is able to identify babies with fetal distress at risk of birth asphyxia, and improve intrapartum FHR monitoring practices among low risk pregnancies in resource limited settings GAP: Among high risk pregnancies, it is not known if use of the MOYO device for continuous intrapartum FHR can improve neonatal outcomes. HYPOTHESIS: We hypothesize that improved intrapartum fetal heart rate monitoring using the MOYO device will reduce early neonatal mortality by atleatst 40% from the current level of 10%. METHODS: This will be a pre and post quasi experimental study, with both qualitative and quantitative components. We will observe a minimum of 1,544 women with at least one risk as described in the Robson criteria (category ≥2), over a period of 12 months. The primary outcome measure will be perinatal mortality (stillbirth and early neonatal deaths within 7 days of life). RESULTS: Pending. IMPACT: Our results will inform the design of a large clinical effectiveness stepped-wedge cluster randomised trial to inform the policy on intrapartum FHRM using the MOYO device. Additional Comments: Introduction of Moyo for continuous FHRM, will be an add on to the already funded Bedside resuscitation study at the same hospital.